RENAL TREATMENT CENTERS - MID-ATLANTIC INC. NPI 1992774939

NPI Information

NPI: 1992774939
Provider Name: RENAL TREATMENT CENTERS - MID-ATLANTIC, INC.

Doing Business As: IRIS CITY DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
521 N EXPRESSWAY STE 1509
GRIFFIN, GA
ZIP 30223
Phone: (770) 228-3177
Get Directions

RENAL TREATMENT CENTERS - MID-ATLANTIC, INC. is an end-stage renal disease (esrd) treatment clinic center in Griffin, GA. RENAL TREATMENT CENTERS - MID-ATLANTIC, INC. NPI is 1992774939. The provider is registered as an organization entity type.
The provider Is Doing Business As Iris City Dialysis.

The provider's business location address is:

521 N EXPRESSWAY STE 1509
GRIFFIN, GA
ZIP 30223-073
Phone: (770) 228-3177
Fax: (770) 229-8431

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp Licensure&certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 11D0994181 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/14/2006 and was last updated on 4/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	ESRD001211	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000479476C	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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